Trends of complications and innovative techniques' utilization for colectomies in the United States.
Aged
Aged, 80 and over
Colectomy
/ adverse effects
Elective Surgical Procedures
/ adverse effects
Female
Humans
Laparoscopy
/ adverse effects
Length of Stay
/ statistics & numerical data
Male
Postoperative Complications
/ epidemiology
Procedures and Techniques Utilization
/ statistics & numerical data
Robotic Surgical Procedures
/ adverse effects
Safety
United States
/ epidemiology
Colectomy
Laparoscopic
Open
Robotic
Surgical complications
Trend analysis
Journal
Updates in surgery
ISSN: 2038-3312
Titre abrégé: Updates Surg
Pays: Italy
ID NLM: 101539818
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
12
06
2020
accepted:
31
07
2020
pubmed:
11
8
2020
medline:
4
8
2021
entrez:
11
8
2020
Statut:
ppublish
Résumé
Despite an increasing trend towards utilization of minimally invasive approaches (MIS), results regarding their safety profile are contradictory. All patients who underwent elective colectomy for any underlying disease with an identifiable operative approach available from the targeted colectomy files of the ACS-NSQIP PUFs 2013 to 2018 were included. The trend of utilization and complication rates of the different operative approaches (open, laparoscopic, robotic) were assessed during the inclusion period. Furthermore, overall, surgical, and medical complications were compared between the three approaches. The study cohort included 78,987 patients. Of them, 12,335 (15.6%) patients underwent open, 57,874 (73.3%) laparoscopic, and 8,778 (11.1%) robotic surgery. There was an increasing trend towards the utilization of robotic surgery (2.5% increase per year) at the expense of the other approaches. With the increasing trend toward the utilization of the robotic approach, a decreasing trend in overall and surgical complications and length of stay was observed. After adjusting for the baseline confounders, robotic surgery was associated with shorter length of stay, lower rate of overall (OR 0.397; p < 0.05 compared to open and OR: 0.763; p < 0.05 compared to laparoscopy) and surgical complications (OR: 0.464; p < 0.05 compared to open and OR: 0.734; p < 0.05 compared to laparoscopy). This study revealed an increasing trend toward the utilization of MIS for elective colectomy in the US. Robotic surgery was associated with a decreasing trend in overall and surgical morbidity and length of stay.
Identifiants
pubmed: 32772277
doi: 10.1007/s13304-020-00862-y
pii: 10.1007/s13304-020-00862-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
101-110Références
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